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Can stomach cancer be prevented?

There is no sure way to prevent stomach cancer, but there are things you can do that could lower your risk.

Diet, nutrition, body weight, and physical activity

The dramatic decline of stomach cancer in the past several decades is thought to be a result of people reducing many of the known dietary risk factors. This includes greater use of refrigeration for food storage rather than preserving foods by salting, pickling, and smoking. To help reduce your risk, avoid a diet that is high in smoked and pickled foods and salted meats and fish.

A diet high in fresh fruits and vegetables can also lower stomach cancer risk. Citrus fruits (such as oranges, lemons, and grapefruit) may be especially helpful, but grapefruit and grapefruit juice can change the blood levels of certain drugs you take, so it’s important to discuss this with your health care team before adding grapefruit to your diet.

The American Cancer Society recommends that people eat a healthy diet, with an emphasis on plant foods. This includes eating at least 2½ cups of vegetables and fruits every day. Choosing whole-grain breads, pastas, and cereals instead of refined grains, and eating fish, poultry, or beans instead of processed meat and red meat may also help lower your risk of cancer.

Studies that have looked at using dietary supplements to lower stomach cancer risk have had mixed results so far. Some studies have suggested that combinations of antioxidant supplements (vitamins A, C, and E and the mineral selenium) might reduce the risk of stomach cancer in people with poor nutrition to begin with. But most studies looking at people who have good nutrition have not found any benefit to adding vitamin pills to their diet. Further research in this area is needed.

Although some small studies suggested that drinking tea, particularly green tea, may help protect against stomach cancer, most large studies have not found such a link.

Being overweight or obese may add to the risk of stomach cancer. On the other hand, being physically active may help lower your risk.

Avoiding tobacco use

Tobacco use can increase the risk of cancers of the proximal stomach (the portion of the stomach closest to the esophagus). Tobacco use increases the risk for many other types of cancer and is responsible for about one-third of all cancer deaths in the United States. If you don’t use tobacco, please don’t start. If you already do and want help quitting, call the American Cancer Society at 1-800-227-2345.

Treating H pylori infection

It is not yet clear whether people whose stomach linings are chronically infected with the H pylori bacteria but who do not have any symptoms should be treated with antibiotics. This is a topic of current research. Some early studies have suggested that giving antibiotics to people with H pylori infection may lower the number of pre-cancerous lesions in the stomach and may reduce the risk of developing stomach cancer. But not all studies have found this. More research is needed to be sure that this is a way to prevent stomach cancer in people with H pylori infection.

If your doctor thinks you might have H pylori infection, there are several ways to test for this:

The simplest way is a blood test that looks for antibodies to H pylori. Antibodies are proteins the body’s immune system makes in response to an infection. A positive H pylori antibody test result can mean either that you are infected with H pylori or that you had an infection in the past that is now cleared.

Another approach is to have an endoscopy procedure (see the section “How is stomach cancer diagnosed?”) to take a biopsy sample of the stomach lining. This sample can be used for chemical tests for this kind of bacteria. Doctors can also identify H pylori in biopsy samples viewed under a microscope. The biopsy sample can also be cultured (placed in a substance that promotes bacterial growth) to see if H pylori grows out of the sample.

There is also a special breath test for the bacteria. For this test, you drink a liquid containing urea. If H pylori is present, it will chemically change the urea. A sample of your breath is then tested for these chemical changes.

Aspirin use

Using aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen, seems to lower the risk of stomach cancer. These medicines can also lower the risk of developing colon polyps and colon cancer. But they can also cause serious (and even life-threatening) internal bleeding and other potential health risks in some people.

Most doctors consider any reduced cancer risk an added benefit for patients who take these drugs for other reasons, such as to treat arthritis. But doctors do not routinely recommend taking NSAIDs specifically to prevent stomach cancer. Studies have not yet determined for which patients the benefits of lowering cancer risk would outweigh the risks of bleeding complications.

For people at greatly increased risk

Only a small percentage of stomach cancers are caused by hereditary diffuse gastric cancer syndrome. But it is very important to recognize it, because most people who inherit this condition eventually get stomach cancer. A personal history of invasive lobular breast cancer before age 50 as well as having close family members who have had stomach cancer suggests that they might be at risk for having this syndrome. These people can talk to a genetics professional about getting genetic testing. If the testing shows the person has a mutation (abnormal change) in the CDH1 gene, many doctors will recommend they have their stomach removed before the cancer develops.